ATLANTA -- Women who binge eat may be at greater risk of developing type 2 diabetes, regardless of how heavy they are, researchers reported here.

Action Points

Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Note that this cohort study demonstrated an association between binge eating behavior and the development of type 2 diabetes among adolescent girls.

Be aware that the overall event rate was very low, limiting the authors' ability to control for potential confounders.

ATLANTA -- Women who binge eat may be at greater risk of developing type 2 diabetes, regardless of how heavy they are, researchers reported here.

In a cohort study of about 4,300 girls, those who binged frequently -- without "purging," or using laxatives or vomiting after a big meal -- had nearly a four-fold increased risk of developing type 2 diabetes, even after controlling for body mass index (OR 3.93, 95% CI 1.27 to 12.13), Alison Field, ScD, of Boston Children's Hospital, and colleagues, reported at Obesity Week here.

That association was strengthened after controlling for the mother's own history of type 2 diabetes, Field reported.

Binge eating involves taking in a large amount of food, which is usually highly processed and high in carbohydrates, especially sugar, Field said. This initiates a hefty insulin response, which could cumulatively exhaustthe beta cells, raising the risk of insulin resistance.

Although there's a clear pathway linking binge eating with type 2 diabetes, Field said, the relationship hasn't been studied.

So she and her colleagues assessed prospective data from the Growing Up Today Study (GUTS) -- a longitudinal cohort of offspring of women from the Nurses' Health Study. These children had information on eating disorder behaviors collected annually from 1996 to 1999. The researchers followed them through 2010 to assess development of type 2 diabetes.

In total, the study included 4,323 female patients, who had a mean age of 15 and a mean BMI of 20.93; only about 13% of girls were overweight and only 4% were obese.

There were 49 cases of diabetes that developed during follow-up.

The overall prevalence of binge eating was low, with only 1.77% of girls binge eating weekly, 1.36% having a diagnosed binge eating disorder, and 4% meeting other characteristics of very minor binge eating.

Overall, the researchers found that girls who binged frequently were significantly more likely to develop type 2 diabetes during follow-up, even after controlling for BMI (OR 3.93, 95% CI 1.27 to 12.13).

That finding was strengthened after controlling for maternal history of type 2 diabetes, (OR 4.77, 95% CI 1.70 to 13.42).

In further analyses, the relationship between binge eating and diabetes was strongest among girls with a full binge eating disorder -- and when those findings were controlled for maternal history of type 2 diabetes (OR 5.95, 95% CI 1.45 to 24.30).

There was no association between less frequent binge eating and risk of developing diabetes, Fried added.

The study may be limited in its generalizability because more than 90% of the sample was white, and because type 1 diabetics were excluded.

Still, the researchers concluded that girls who frequently binge eat are at high risk for developing diabetes, independent of their weight status.

Field recommended that clinicians look for signs of binge eating in their adolescent and young adult patients. With further work, she added, prevention and treatment of binge eating may be a possible intervention for type 2 diabetes risk reduction.

The researchers reported no conflicts of interest.

Reviewed by F. Perry Wilson, MD, MSCE Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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